摘要
目的:观察趋化因子CCL5在类风湿关节炎患者体内的产生来源,以及CCL5水平与类风湿关节炎的症状和实验室检查指标的相关性。方法:选择2004-06/10遂宁市人民医院及川北医学院附属医院收治的类风湿关节炎患者28例,以同期收治的骨关节炎患者21例为对照。所有患者取空腹外周血,有膝关节积液的11例类风湿关节炎患者和6例骨关节炎患者同时抽取关节液。用酶联免疫吸附法测定两组患者血清及滑液中CCL5水平,并对患者外周血白细胞和滑液炎性细胞体外产生CCL5进行检测。用直线相关回归分析法分析类风湿关节炎患者血清CCL5水平与关节肿胀指数、血沉、C反应蛋白之间的相关性。结果:49例患者进入结果分析。①CCL5水平:血清中类风湿关节炎患者明显高于骨关节炎患者[(911±388),(499±289)ng/L,P<0.05];滑液中类风湿关节炎患者也明显高于骨关节炎患者[(1390±187),(662±154)ng/L,P<0.01];而且类风湿关节炎患者滑液中CCL5水平明显高于血清中(P<0.01)。②相关性分析:类风湿关节炎患者血清CCL5水平与关节肿胀指数、血沉、C反应蛋白呈正相关(r=0.3229,0.4001,0.3735,P<0.05)。③白细胞体外产生CCL5水平:类风湿关节炎患者滑液明显高于外周血和骨关节炎患者滑液(P<0.05);但两组患者外周血白细胞体外产生CCL5无差异(P>0.05)。结论:①类风湿关节炎患者血清CCL5水平增高,且与类风湿关节炎的活动性病变(关节肿胀指数、血沉、C反应蛋白)有显著相关性,表明CCL5在类风湿关节炎的病理过程中起重要作用。②患者滑液炎性细胞是CCL5产生的主要来源。
AIM： To observe the source of production of CC ehemokine CCL5 in vitro of rheumatoid arthritis patients and the relationship of level of CCL5 with symptom of rheumatoid arthritis and index of laboratory examination.
METHODS： Twenty-eight patients with rheumatoid arthritis were selected from Suining Municipal People＇s Hospital and Affiliated Hospital of North Sichuan Medical College between June and October 2004. Twenty-one patients with osteoarthritis were selected as control in the same period. Peripheral blood was extracted from all the fasting patients. Joint fluid was extracted from 11 rheumatoid arthritis patients with effusion of knee joint and 6 osteoarthritis patients. The level of CCL5 in serum and synovial fluid of the patients inthe two groups was detected with enzyme-linked immunosorbent assay. The CCL5 produced in white cells in peripheral blood and inflammatory cell in the synovial fluid was tested. The relationship of serum CCL5 level with joint swollen index, erythrocyte sedimentation rate （ESR） and C-reactive protein （CRP） in rheumatoid arthritis patients was statistically analyzed with linear correlation regression analysis.
RESULTS： Forty-nine patients were involved in the result analysis. CCL5 level： Serum CCL5 level in the rheumatoid arthritis patients was higher significantly than that in the patients with osteoarthritis [（911±388）, （499±289） ng/L, P〈0.05]. The CCL5 level in the synovial fluid in the rheumatoid arthritis patients was higher significantly than that in the patients with osteoarthritis [（1 390±187）, （662±154） ng,/L, P 〈 0.01]. The CCL5 level in the synovial fluid was higher significantly than that in the serum in the rheumatoid arthritis patients（P 〈 0.01）. ②Correlation analysis： The serum CCL5 level has positive correlation with joint swollen index, ESR and CRP in the rheumatoid arthritis patients （r=0.322 9,0.400 1, 0.373 5,P 〈 0.05）. ③Production of level of CCL5 in leucocytes in vitro： It was higher significantly in the synovial fluid of rheumatoid arthritis pa- tients than that in the synovial fluid of peripheral blood and patients with osteoarthritis （P 〈 0.05）. But the production of CCL5 in the leucocytes of peripheral blood in vitro of patients in the two groups had no difference（P 〈 0.05）.
CONCLUSION： ①The level of serum CCL5 in rheumatoid arthritis patients increases, and have significant correlation with the lesion of activity of rheumatoid arthritis （joint swollen index, ESR and CRP）, which show that the CCL5 plays an important role in the pathological process of rheumatoid arthritis. ②Inflammatory cell of synovial fluid of the patients is the main source of causing the production of CCL5.
出处
《中国临床康复》
CSCD
北大核心
2006年第4期131-133,共3页
Chinese Journal of Clinical Rehabilitation
基金
四川省卫生厅科研基金资助项目(010061)~~
